- Penn State Health (Hershey, PA)
- …**SUMMARY OF POSITION:** Researches, obtains authorizations, insurance verifications, clinical documentation , prescription information and financial ability ... when a prescriber writes a Specialty (high price, high risk and high touch) medication, so that the patient...in Prior Authorizations in either a Pharmacy or a Clinical setting required. **KNOWLEDGE, SKILLS, & ABILITIES:** Ability to… more
- Baylor Scott & White Health (Harrisburg, PA)
- …**KEY SUCCESS FACTORS** + Knowledge of ICD-10-CM and CPT coding conventions, and clinical documentation + Knowledge of and compliance with standards of ethical ... + Conducts provider audits and creates provider scorecards to offer feedback on Risk Adjustment Methodology + Interprets health record documentation to code and… more
- Highmark Health (Harrisburg, PA)
- …requesting and obtaining medical records from healthcare providers to ensure accurate documentation of members' health conditions and optimize risk adjusted ... Health Record (EHR) systems preferred. + Proficiency in navigating and retrieving clinical information from EMR/HER systems + Working knowledge of HIPAA requirements… more
- Highmark Health (Harrisburg, PA)
- …requesting and obtaining medical records from healthcare providers to ensure accurate documentation of members' health conditions and optimize risk adjusted ... Health Record (EHR) systems preferred. + Proficiency in navigating and retrieving clinical information from EMR/HER systems + Working knowledge of HIPAA requirements… more
- Highmark Health (Harrisburg, PA)
- …Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier ... areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in… more